Wednesday, March 7, 2012

The Patient I Want To...Punch In the Face

I have an obese diabetic patient who I just want to deck in the face. I HATE disrespectful, know-it-alls, particularly when they are grown men who act like a child. This man is utterly convinced that because he was an EMT earlier in his life and because he spent 55 days at Mass General Hospital, he knows more than every specialist, hospitalist, doctor, nurse, case manager, director, dietitian, social worker and therapist who is involved in this man's care. GET. OUT. NOW.

Apparently some doctor placed this man on a hybrid insulin and so the patient self-administers his own insulin. Uh...OK. The amount he administers is INSANELY high and it's basically whatever he wants. He estimates and guesses. I mean there's a difference between carb counting and estimating on that, and just shooting yourself up with a HUGE amount of insulin so you can eat whatever you want.

Upon our first--which would become a series of very unfortunate and VERY frequent--visit he informed me he needed more carbohydrates and after bypassing the restriction I got an urgent call from our response center saying he was eating well over 3500 calories. Listen here, porkchop, you DO NOT need to have that many calories to meet your carbohydrate needs.

So enter the battlefield I did.

This patient informed me that sugar and carbohydrates are not the same thing. Uh...OK. And that swiss cheese and American cheese have differing influences of your blood sugar. Uh...OK...MINUS the fact that cheese is considered a "free" food buddy. But hey, what do I know? He's the "expert EMT" genius. It's people like this who make my blood boil.

Well, I busted out my charm, threw down a few jokes, eased the tension, and we bonded. BAD, BAD, BAD move. Every day since then I get paged anywhere from 1-10 times per day with complaints. He whines he's not getting enough food and that's why his blood sugars dip, waaa waaa waaa. Yeah ok. STOP SHOOTING YOURSELF UP WITH SO MUCH FREAKIN' INSULIN!!!!!!! FOR THE LOVE. Moron. I got paged, I'm not kidding you, 8 times today about every little thing. You see I have patients who actually require my attention and intervention, like the patient who can't eat because his intestines are blocked and is on TPN (nutrition through a tube stuck in your veins). I couldn't care less that you were missing your stupid fork with your snack, especially since there are plastic forks available ON THE FLOOR IN THE KITCHEN 5 FEET AWAY FROM YOUR DOOR!!! QUIT WASTING MY TIME!!!! 2 1/2 hours of my time!!!! Oh my lantus I wanted to pop him in the gut today. *deep breaths* Oh and then I got paged because the kitchen was out of sausage patties and he wanted to speak to me. So I went into his room and he told me the kitchen called to say they were out of sausage and he wanted to know what to order. OH. MY. LANTUS. What are you, 4???? So ladies and gentlemen I had to order his meal for him, and when he didn't get his Swiss cheese he refused his entire tray. He better not page me tomorrow or Angry Ginge will make an appearance. And if I have to listen to him tell me ONE MORE TIME about his hybrid insulin, or that fact that he was a patient at Mass General, or call me sweetie and repeat that same freakin' sob story to me for the 15th time (apparently I'm doubling as his therapist too), I'm going to stuff white bread in his mouth, WITH CHEESE! *gasp* And to top it all off, he keeps calling me Gabby. Imma bust a cap on this fool.

Oh and my favorite thing with him is, if he doesn't get his way, he threatens to sign himself out against medical advice and then when we tell him we are discharging him home, he throws a hissy fit, refuses therapy, complains he can't breathe. Oh it is a theatrical performance at its finest. Two thumbs and four stars. I've seen identical performances from 4-year-old children that I babysit. Nicely done you over-sized baby in a man's body.

Yeah. It's been that kind of a day/week.

In other news my fruit leather came out...kind of. I don't have a food processor or blender so it wasn't a very homogeneous, smooth consistently to begin with. Oh well!

This is what it looked like when I peeled it off the plastic:

Then I rolled it....

Then I ate it.

YUM!

Recipe here. Yes it does take 12-16 hours, but you can break it up. I did not use sugar. I used strawberries, lemon juice, a dash of vanilla (which I highly recommend) and maybe 1-2 tsp of sugar substitute. It's awesome. Make it. Eat it. Love life.

Moi

My full name is Gabrielle (gabe-ree-elle) but please call me Gabe (but NEVER Gab or Gabby). Yes, I KNOW it's usually a boy's name, but, I'm a girl! I love ice cream and gelato quite possibly more than anything. I use exclamation points more often than I should and I like it that way. I am an New Englander in my heart and soul. I'm a dreamer, a big one. I'm very passionate...especially about sports, correct grammar, New England, autumn, shoes, learning and food (I'm a registered dietitian {RD}). I bake a lot. I'm insatiably curious. Books are some of my most prized possessions. I love my life, especially with freckles. Enjoy my thoughts!